A piece of skull is often kept off the patient to allow for swelling; the skull might actually be buried under a flap of skin and fat tissue to keep the bone alive(saw it a quite a few times). Mannitol and steroids might be used to control swelling and nimodipine to avoid vascular spasm. Careful icp monitoring will be employed and measures taken to keep the intracranial pressure down. Pain control measures may include codeine IM or morphine IV...(not fentanyl as it can actually INCREASE intracranial pressure). Codeine is a good drug of choice as it is more “neuro motor response friendly” or it doesn’t intefere with neuro assessments other than obvious and expected drowsiness, while morphine is good if a more calmer “brain cooling” state is needed to be maintained. Propofol, versed, ativan and/or precedex IV drips may be employed to keep the patient calm while sedated.
There is a lot that can be done, and I suspect the congresswoman can do well, though it will take up to 6 months before we know what she functionality she’ll keep and what she’ll lose
I meant “calm while intubated”. Sheesh, I’m going to bed!